Battling acid reflux

Thursday

Feb 25, 2010 at 12:01 AM

Melissa Joseph of Dingmans Ferry is one of nearly 25 million Americans who experience the many symptoms of acid reflux. She's been dealing with this condition on a daily basis for years with little relief. Gastroesophagus reflux disease, better known as acid reflux, strikes a large percentage of the population, with 70 percent experiencing the most common symptom.

MELANIE VANDERVEER

Melissa Joseph of Dingmans Ferry is one of nearly 25 million Americans who experience the many symptoms of acid reflux. She's been dealing with this condition on a daily basis for years with little relief.

Gastroesophagus reflux disease, better known as acid reflux, strikes a large percentage of the population, with 70 percent experiencing the most common symptom.

Charles Cohan, D.O., of Pocono Gastroenterology in East Stroudsburg, noted that the classic symptom is heartburn: a burning sensation in the lower part of the chest and upper abdomen. "It's pretty easy to make the diagnosis with this symptom alone. In addition to the classic reflux symptom, there is another common symptom: regurgitation," he said.

Joseph's symptoms go a few steps further than just the classic heartburn.

"I wake up in the morning tasting acid in my mouth," she said. "My throat feels constricted and I have a lump in my throat. It feels like there is air trapped in my chest and burning in the back of my throat."

Other symptoms of acid reflux can include nausea, bloating, hoarseness, dental issues, water brash (hyper salivation), globus sensation (feeling that something is stuck in the throat) and a cough.

"Some people get diagnosed with asthma because of the cough," Cohan said. "They are initially sent to a pulmonary doctor for tests, and when they realize there is no basis for asthma, the patient is sent to a gastroenterologist."

For the occasional acid-reflux sufferer, over-the-counter medication usually does the trick. But for the more severe symptoms, it just might not make enough of a difference.

"I've tried all the medications and none have worked," said Joseph, who has seen several doctors about this issue. She is not Cohan's patient. "I'm now trying alternative therapies — aloe vera, acidophilus and propping up the head of the bed."

There are times when a person is diagnosed with acid reflux but it turns out to be something a little more serious. Heart attacks can mirror the symptoms of acid reflux for some adults. For infants, pyloric stenosis, a condition in which the pylorus — the lower part of the stomach that connects to the small intestine — narrows, making food unable to pass. This forces projectile vomiting. The first condition that is usually thought of in these babies is acid reflux. Surgery is necessary to fix pyloric stenosis.

Other than medication, Cohan said that lifestyle changes can bring on great results for most patients.

"Mild to moderate cases can do other things to help treat the symptoms. Dietary and behavioral modification can help," said Cohan. "The worst thing someone with acid reflux can do is to lie down within two hours of eating a meal. You shouldn't lie down with a mixture of food and acid in the stomach. People with acid reflux should lie down with an empty stomach."

Cohan said that trigger foods are fatty foods, chocolate, mints, spicy foods and tomato sauce. Certain beverages are also triggers. Orange, pineapple, citrus and tomato juice, as well as lemonade and alcohol, are all triggers. "Tight clothing puts pressure on the abdomen and tends to increase acid reflux. Anyone that is obese or smokes is at risk," he said.

While Cohan said that it isn't easy to completely change your lifestyle, he said any little bit helps. His office hands out papers that point out lifestyle modifications.

"We realize no one is going to change their entire diet. Most people respond really well to changing," Cohan said. "There is flexibility to eat more liberally if you take medications."

Many people with symptoms end up having tests done to determine the severity of the disease. An upper endoscopy is usually the first test done.

"I will do an endoscopy, and if there is no evidence of Barrett's esophagus, a complication of chronic acid reflux, I won't do another one unless symptoms worsen," Cohan said. "Some patients will have a 24-hour pH test done, which is a probe into the esophagus to measure the presence of acid in the esophagus. Another test is an esophageal manometry that measures the pressure in the esophagus and measures the strength of the lower esophagus sphincter muscle."

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